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When wearing a mask is not enough: new precautions for the winter coronavirus firestorm

COVID-19 graffiti

After living with the pandemic for months, it’s easy to believe we’re all coronavirus veterans. We’re comfortable in our new routines and safety protocols, and our masks are beginning to feel, well, almost normal.

But we’re heading into a such a firestorm of COVID cases, our routines need to change once again. This winter will be different than anything we’ve experienced so far.

“What America has to understand is we are about to enter COVID hell,” explained Dr. Michael Osterholm, Biden coronavirus advisor and director of the Center for Infectious Disease Research and Policy at the University of Minnesota. “We have not even come close to the peak and, as such, our hospitals are now being overrun. The next three to four months are going to be, by far, the darkest of the pandemic.”

CNN’s Dr. Sanjay Gupta calls it a “humanitarian disaster” the likes of the Haiti earthquake and the Indonesia tsunami. “I don’t say this lightly,” he adds, citing IHME’s forecast that 438,000 Americans will die by March.

Sure, there are very promising developments on the vaccine front, but distribution to the general public won’t come soon enough to help this winter (April is a “guesstimate,” says Dr. Anthony Fauci). The virus is worse than you think, and human behavior is slow to adapt – both at home and at work – as we approach the critical holiday season.

Masks and social distancing have been drilled into our brains for months. While they’re critically important, those precautions alone are not enough as people head indoors for the winter. A growing body of scientific evidence finds that prolonged, poorly-ventilated indoor gatherings are a petri dish for spreading COVID — even if you’re wearing a mask AND remaining six feet apart from others.

A computer model (above) from the University of Colorado illustrates what happens when six people, one carrying COVID-19, gather in a poorly-ventilated room for four hours. Even though they’re all wearing masks and distancing, four are likely to catch the coronavirus. If you open the window and reduce the time to two hours, the risk of infection drops dramatically.

That’s why the CDC’s new guidance for holiday gatherings is to only “celebrate with people in your household.” But if you must gather with others, “have a small outdoor meal with family and friends who live in your community” while wearing a mask and distancing, too. The CDC even offered an illustration:

Regardless of the warnings, millions of Americans plan to travel this holiday season to gather with family members outside their household. Many will meet indoors. Some will bring their college students home, unquarantined. In fact, a national survey from Ohio State University’s Wexner Medical Center finds that nearly two in five Americans report they will likely attend a holiday gathering with more than 10 people. One-third of those surveyed will not ask guests to wear masks.

It’s not just the holidays. All indoor gatherings pose a risk – heightened by lower ventilation, higher occupancy and more time spent – according to a growing chorus of guidance from health experts.

“Socialize outdoors only during the surge,” explained Dr. Leana Wen, an ER doctor at George Washington University and CNN medical analyst.

But while the CDC urges families to hold holiday gatherings outdoors, its workplace guidance tells a different story. By and large, industry-specific guidance emphasizes masks, distancing and disinfection over ventilation, occupancy and time spent in indoor spaces.

Of course, the states control which businesses remain open – at what occupancy levels – and federal workplace guidance has been a thorny political issue. But employers should recognize this disconnect and take the appropriate proactive steps to ensure employees are safe during the most dangerous pandemic surge we’ve ever experienced in modern times.

“When community transmission is this high, every kind of exposure is more dangerous. A gym class is more likely to have someone who is infectious. Workplaces will have more cases, meaning more employees will unknowingly bring the virus home. More people at the grocery store will be positive,” explains sociologist Zeynep Tufekci in The Atlantic. “It’s time to buckle up and lock ourselves down again, and to do so with fresh vigilance.”

Even with careful precautions, people are still contracting COVID as community spread explodes. A journalism professor at University of Nebraska-Lincoln, Matt Waite said he became infected despite wearing masks, getting “contactless everything” and even avoiding the grocery store.

“Everyone tells you wear a mask and wash your hands,” he wrote in a thread on Twitter. “I did all that. We’re past that point. It’s rampant right now. You need to stay home unless it’s life or death. Don’t be around anyone until this passes.”

(This blog post was adapted from the Factal-Emergent Risk International webinar on COVID-19 held on Nov. 12th. We hold these webinar briefings every two weeks. Sign up to attend here. Post updated on Nov. 15. Top image from Adam Nieścioruk on Unsplash.)